go back

California rates for HCPCS G9878

Two Medicare Diabetes Prevention Program (MDPP) core maintenance sessions (MS) were attended by an MDPP beneficiary in months (mo) 7-9 under the MDPP Expanded Model (EM). A core maintenance session is an MDPP service that: (1) is furnished by an MDPP supplier during months 7 through 12 of the MDPP services period; (2) is approximately 1 hour in length; and (3) adheres to a CDC-approved DPP curriculum for maintenance sessions. The beneficiary achieved at least 5% weight loss (WL) from his/her baseline weight, as measured by at least one in-person weight measurement at a core maintenance session in months 7-9

Facilitymedian $79 · 10th–90th $49–$1780%10%20%10th90th$79Professionalmedian $65 · 10th–90th $46–$1100%10%20%10th90th$65$0.0$0.2$2.0$20.0$200.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$48.98 / $48.98 / $95.50
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $67.61 / $102.33
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22.91 / $57.54 / $239.88
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $47.86 / $47.86
Contra Costa Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $47.86 / $57.54
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $257.04 / $831.76
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$363.08 / $363.08 / $363.08
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $467.74 / $467.74
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $60.26 / $60.26
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$50.12 / $77.62 / $131.83
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $47.86 / $53.70
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$57.54 / $57.54 / $57.54
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $64.57 / $117.49